Fast Five Quiz: Mycoplasma genitalium

Ken B. Waites, MD

Disclosures

April 09, 2020

A test of cure is recommended for all patients after treatment for M. genitalium infection.

Guidelines from the Centers for Disease Control and Prevention (CDC) note that M genitalium lacks a cell wall and, as such, antibiotics targeting cell-wall biosynthesis (eg, beta-lactams, including penicillins and cephalosporins) are not effective against this organism.

The 7-day doxycycline regimen that is recommended for the treatment of urethritis is essentially ineffective against M genitalium, with a median cure rate of approximately 31%. According to BASHH, one effective treatment of uncomplicated urogenital infection (urethritis, cervicitis) in patients with M genitalium where the organism is known to be macrolide-sensitive or where resistance status is unknown consists of 7 days of doxycycline 1000 mg twice daily, followed by a single dose of azithromycin 1 g orally, followed by azithromycin 500 mg once daily for 2 days.

Moxifloxacin 400 mg once daily for 10 days can be used for the treatment of uncomplicated urogenital infection (urethritis, cervicitis) in patients with M genitalium if it is known to be macrolide-resistant or where treatment with azithromycin has failed. Treatment of complicated urogenital infection (PID, epididymo-orchitis) may consist of moxifloxacin 400 mg once daily for 14 days.

Learn more about the CDC recommendations on the treatment of M genitalium infection.

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